Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

More Helicopter EMS Politics and Pork in Maryland

In the comments to Medevac Helicopter Improvement Act of 2009 – Maryland SB 650, Gray wrote:

Is there a for profit 7×24 medivac service that operates in the black? Doubtful. Do they operate very closely with favored hospital service providers? Count on it. Is their objective life saving or profit?

That describes the relationship between MSP (Maryland State Police) Aviation and Shock Trauma.

For more than 65 years Marylanders have depended on MSP for emergency medical transport in rural areas.

This bill does nothing to decrease availability of care to rural patients.

With the statewide increase in population density and frequency of serious injury traffic crashes MSP has demonstrated its competency in saving lives during that golden hour.

The Golden Hour[1],[2] is a fraud. The Golden Hour is nothing but a marketing tool made up by Dr. R Adams Cowley. When somebody starts telling this lie, it is a good sign that they are selling something. They are not looking out for patients. Why does MSP Aviation keep telling this lie?

Do we have names and dates of the lives saved? No.

Do you have any evidence that this program saves lives, at least more than it kills? Do you have any evidence that this boondoggle is about anything other than political power? No.

But we know how those whose lives have been saved would vote on this issue.. and how their friends and families would vote.

This is a well oiled political machine at work. Here you go for the Huey Long populist approach. This is nothing but politicians working for political power.

Do we value human life enough to continue saving lives, or should we just write that off as a public service, ignoring the vote of the people to fund the service?

That sentence makes no sense. The purpose of the bill is to provide better care to the residents of Maryland. Better care than MSP Aviation has been providing. The residents of Maryland deserve to have responsible people in charge. MSP Aviation will have the opportunity to reform itself and apply for the contract. It will take a lot of reform. Your comment appears to be an attempt to sway the vote of the people to stick with something that is broken; something that has resisted being fixed. The people of Maryland deserve better.

Do rural residents deserve a lesser availability of emergency transport than urban residents? I don’t think so.

MSP Aviation has spent a lot of time on the flight of urban/suburban patients. Patients who would have arrived at the hospital sooner, if they had been transported by ground EMS. If MSP Aviation were interested in the care of these patients, they should have been educating EMS about when not to fly. Instead MSP Aviation was looking for ways to expand. A government organization out of control. A scam.

These were inappropriate flights. When they were criticized for endangering patients, MSP Aviation has refused to improve.

Maryland taxpayers voted for the MSP program, and know it is invaluable, a source of pride and comfort.

That is a great description of pork. They are voting for pride and comfort, but not anything substantial. Maryland voters need somebody responsible to provide better patient care than MSP Aviation seems capable of. MSP Aviation has only one provider to take care of the patient. Why does every other helicopter EMS service have 2 ALS (Advanced Life Support) providers taking care of the patient? Because that is the standard of care. MSP Aviation is substandard.

If you are treating critical patients, you need 2 ALS providers. 2 providers who specialize in the care of critical patients. Not one Trooper/Medic, who dabbles in both patient care and law enforcement. MSP Aviation is a laughing stock when it comes to patient care. This is not quality.

Citing examples of patients flown to Baltimore and walking out of the hospital the next day is a plus: a life saved. That is the idea.

The research showed that most MSP Aviation patients do not need to be flown and may not even need to go to a trauma center.[3] That is not an example of lives saved. That is an example of waste. A life endangered by an unnecessary flight. Other patients endangered because the helicopter is not available for real emergencies. Other patients endangered, because the ground EMS providers learn bad assessment and bad treatment.

Flying uninjured patients around is just putting on a show for the voters. Flying uninjured patients around is not patient care. Flying uninjured patients around is wasteful. Flying uninjured patients around is dangerous. Flying uninjured patients around needs to stop.

This is pork. Which seems to be the idea – Protect our Pork.

MSP’s aviation team may be second to none, while simultaneously wanting it to be still better.

MSP Aviation provides substandard care by all of the criteria that matter. When people have tried to get MSP Aviation to change, they have resisted improvement.

MSP Aviation is only second to none, when there is nobody being compared to them. When they keep everyone out of Maryland, they are the best in Maryland, but they are also the worst in Maryland. MSP Aviation is not up to the standards of helicopter EMS in America.

MSP Aviation – 1980’s care on a modern bloated budget.

That is MSP’s tradition: excellence, integrity, & respect for human life. Emergency life saving should not be relegated to profiteers.

Excellence would be at least providing 2 ALS providers. Even 2 cross-trained sometimes I’m a medic and sometimes I’m a trooper providers would be better than MSP Aviation’s solo trooper/medic – at least, if patient care is important.

Integrity would be addressing this and other serious problems, rather than spending time covering up the problems.

Respect for human life would be putting the patients first, not selling the patient out for political gain.

Emergency life saving has been in the hands of the MSP Aviation profiteers who seek political profit. MSP Aviation has abused their position. MSP Aviation has taken advantage of their patients for political reasons.

MSP Aviation – We’re just a different kind of profiteer.

All talk and no quality care.

Is anybody surprised that there is a demand for somebody else? Somebody who can provide better care.

Footnotes:

[1] The golden hour: scientific fact or medical “urban legend”?
Lerner EB, Moscati RM.
Acad Emerg Med. 2001 Jul;8(7):758-60. Review.
PMID: 11435197 [PubMed – indexed for MEDLINE]

Link to Free Full Text Download in PDF format from Academic Emergency Medicine

[2] City Slickers 2: The Legend of Cowley’s Gold
…or 60 Minutes of Pyrite.
ParaCynic

[3] Helicopter scene transport of trauma patients: a meta-analysis
Bledsoe BE, Wesley AK, Eckstein M, Dunn TM, O’Keefe MO.
Journal of Trauma 2006; 60:1257-1266
PMID: 16766969 [PubMed – indexed for MEDLINE]

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